Introduction: Optokinetic nystagmus, visual evoked cortical potential, forced choice preferential looking have been used to evaluate the visual acuity in infants, but there are limitations to the methods that are objective and easy to apply to clinical practice. We performed this study to describe the development and application of a novel scoring system for grading the ability for fixation and following in infant who are not able to cooperate in testing visual acuity.

Methods: We made the grading system of fixation and follow(FFG) as followed; Fixation: Grade1; no response to target, grade2; response to target but not last > 3seconds, grade3; satisfy the one criteria, grade4; satisfy the two criteria; (1) fix the target lasting > 3seconds (2) move gaze from target to another. Follow: Grade1;poor, grade2;partial, grade3;complete movement. Two ophthalmologist evaluate the FFG of 21 infants. One ophthalmologist (A) repeated the exam within 4 weeks.